1. Technical Field
The technical field relates generally to surgical suturing instrumentation and, more particularly, to a surgical suturing apparatus and a method for suturing vascular tissue sections together.
2. Description of Related Art
During many surgical procedures it is often necessary to join or even rejoin portions of vascular tissues or vessels to form an anastomosis. Various methods of joining vascular tissues to create an anastomosis are used, such as, for example, suturing, stapling or clipping the ends of the vessels together. Additionally, various stents may be used to join the vessels together and create the anastomosis. Where vessels are joined open end to open end it is termed an "end to end" anastomosis. However, in certain surgical procedures it is often desirable to join a free open end of one vessel to an incision in the side of another vessel to create an "end to side" anastomosis or even an incision in the side of another vessel to form "side-to-side" anastomosis.
In some instances suturing of vessels is preferred over stapling or clipping the vessels. Due to the small size of the vessels, a very small suturing needle is used having a length of suture material attached thereto to suture the vessels together. The suturing needle is typically grasped by a needle holder and passed through one vessel and then the opposite vessel. The procedure is repeated to thread or impart a series of stitches to the vessels to suture them together.
Because of the extremely small size of the suturing needle used, typically on the order of ten thousands of an inch in diameter, handling problems may arise while manipulating the suturing needle through the vascular tissues. For example, upon piercing a vessel, the needle must be pushed through the vessel, released by the needle holder at one end of the needle and subsequently grasped at the opposite end of the needle to draw the needle and suture through the vessel thus requiring the release of the needle and suture during the procedure. Release of the needle is often undesirable and may pose problems in regaining control of the needle. To avoid this, it may become necessary to use two needle holders, one positioned on either side of the vessel, to continually grasp the needle, thereby requiring two hands to perform the operation. Additionally, precise control of the needle is often difficult when using typical needle holders. The small size of the needle also makes it difficult and time consuming to recover if dropped during the surgical procedure.
As noted above, the vascular sections to be sutured are typically extremely small. Suturing of such vascular tissue sections is often performed under magnification by equipping the surgeon with special magnifying glasses. The use of these magnifying glasses, while enlarging the view of the vascular tissues and needle, reduces the field of view within which the surgeon has to operate. Thus, as the needle and suture material are passed through the vessels and pulled to draw the suture material through, it often becomes necessary to move the needle holder and needle from the field of view. This may require the surgeon to look away from the field of view containing the vessel sections to be sutured and may present problems in repositioning the needle within the magnified field of view to form another suture in the vascular tissues and increases the time required to suture the vessels together. Even when magnifying glasses are not being used, the surgeon needs to look at the needle as it is moved away from the surgical site to pull the length of suture through the vessel and is passed to his other hand to be re-gripped. Due to the minute size of the vessels, it takes time for the surgeon to refocus on the surgical site to once again pass the needle and suture through the vessel. This repeated change of focus is time consuming and can place a strain on the surgeon's eyes.
Thus, it would be advantageous to have a surgical suturing apparatus and a method of suturing vessels which are particularly suited to suturing vascular tissues in anastomosis procedures. It would further be advantageous to have a surgical suturing apparatus which is operable with a single hand and is capable of maintaining precise and constant control of the needle as it is passed from one needle holding arm of the apparatus to another to avoid release of the needle during the suturing operation. It would also be advantageous to have a surgical suturing apparatus which is capable of suturing vascular tissue sections together with limited hand, apparatus and needle movement in order to maintain the entire suturing operation within a restricted field of view.